Short report: Transition to International Classification of Diseases, 10th Revision and the prevalence of autism in a cohort of healthcare systems.
Musu M Sesay, Courtney E McCracken, Christine Stewart and 12 others
PMID 38240250WHAT IT FOUND
The switch to the new medical coding system did not cause sudden jumps in autism diagnosis rates.
Increases in young children reflect a gradual trend of earlier screening, not a coding artifact. Historical data comparing autism prevalence before and after the change remains valid.
Key findings
01There was no evidence of sudden changes in autism diagnosis rates before and after the transition to the new coding system in any youth age group.
02For children aged 0-5, the increasing trend in diagnosis rates observed before the coding change continued at the same rate afterward, with no significant shift.
03For adolescents aged 12-17, the overall rate of autism diagnosis was stable before the transition and showed a significant decrease in the trend rate afterward.
STILL TO COME
How it was doneWhat they found
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What it does not show
The study did not analyze specific subtypes of autism codes (e.g., distinguishing between Asperger’s and Autistic Disorder), so it cannot rule out shifts in how specific diagnoses were recorded. The data comes from integrated healthcare delivery systems, which may not represent the general population or other healthcare models. Some sites had missing enrollment data for certain months in the post-transition period. The analysis covers only a 30-month window (15 months before and after the change), which may not capture longer-term trends.
Declared interests
The study was supported by the National Institute of Mental Health and the Centers for Medicare & Medicaid Services. The authors declared no competing interests.
The easy way to misread this
Do not assume that all increases in autism diagnosis rates are due to better coding or administrative changes. The study found that the rise in diagnoses for young children was a gradual trend likely driven by increased early screening and awareness, not the switch to the new coding system.